By using motor developmental status as the outcome measurement, Dietrich et al,1 in the current issue, have tried to lend objectivity to the controversial question of whether neurologic damage in childhood can be attributed to low lead (Pb) levels. Previous prospective studies have shown a lack of consistency between Pb exposure and many measurements of cognitive development and language skills. Children who have elevated blood Pb levels are frequently subject to other neurologic risk conditions, including poverty, disorganized family situations, low maternal intelligence (IQ) and education, and poor nutrition, particularly anemia. The problem is to separate the effect of Pb from the confounding variables.

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